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• 0 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY} PERMIT# 0 k2 0 2—dl-2 <br /> BUILDING PLANNING <br /> Intake OK by: Yr7 Date: 1gf24:0-+---- Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> RI Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 324,5 - +' ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone LlZ- <br /> Number of Stories 1 Overlay/Agreement _ <br /> Basement ENo ❑Yes , Fin/Unfin Nonresidential Use I 4r i L,)I O'-p <br /> Type of Construction Ve'' Residential Use J <br /> Occupancy Group F - i. Proposed No.of Dwelling Units: <br /> Occupancy Load 2.2 Total No.of Dwelling Units: <br /> Fire Sprinklers: 14Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ISINo <br /> Reason Sprinklers "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: IwUpdate Existing ❑New System Mot Req'd School Impact Fee: Total $ - <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ID No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: 5?.32. (4102 S �- ,6 CO) <br /> VALUATION CALCULATION: Total$ Srvo/oao �` <br /> Approved By: V , - 4 Date: 2,ii ZZ <br /> PUBLIC WORKS 11 <br /> Intake OK by: . Date: _ _ <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> � <br /> ❑Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: 24 g,Z,/,t gp.Z _❑Backflow Prevention for high hazard: <br /> 11 :(dental,medical,animals,mortuary,hospital, <br /> :supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> Aire Sprinklers €ire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: rglThis Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items fl <br /> Fire Dept.Fees: ❑ A Separate PW Permit is Required (Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> 4Ki-Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: V.; Co(AJli Date: .'' '"'X01 ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: 6 � 10 (ifA <br /> ELECTRICAL Nt a4tr4 pi UUil _ ��+�; "� '1 <br /> Additional Notes: dfi a 9 t S d. ( C on Iv 9Fi tJ <br /> Approved By: Date: Approved By: Date: aa <br />